scholarly journals EFFICACY OF 5% POTASSIUM HYDROXIDE VERSUS 10% POTASSIUM HYDROXIDE SOLUTION FOR THE TREATMENT OF MOLLUSCUM CONTAGIOSUM AT A TERTIARY CARE HOSPITAL

2021 ◽  
Vol 71 (6) ◽  
pp. 2135-38
Author(s):  
Hina Saleem Baloch ◽  
Najia Ahmed ◽  
Arfan Ul Bari ◽  
Omer Farooq ◽  
Abdullah Ahmad Waqar Qureshi
Keyword(s):  
Potassium Hydroxide ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Potassium Hydroxide Solution ◽  
Complete Response ◽  
Molluscum Contagiosum ◽  
Care Hospital ◽  
Dermatology Department ◽  
Quasi Experimental

Objective: To compare the efficacy of 5% potassium hydroxide (KOH) and 10% potassium hydroxide (KOH) solution for the treatment of molluscum contagiosum at a tertiary care Hospital. Study Design: Quasi-experimental study. Place and Duration of Study: Dermatology Department, Tertiary Care Hospital Karachi, from Oct 2019 to Apr 2021. Methodology: Sixty patients with molluscum contagiosum who fulfilled the inclusion and exclusion criteria were enrolled in the outpatient department of tertiary care hospital in Karachi. Patients were divided into two groups, A (5% KOH) and B (10% KOH) of 30 patients each. Potassium Hydroxide (KOH) solution was applied at home using the cotton-tipped applicator twice daily. Follow-up of patients was done at 2-weekly intervals for 12 weeks. Efficacy was measured based on the resolution of lesions or improvement from baseline. Results: Complete response occurred in 23 (76.7%) cases in 10% KOH Group while 6 (20%) in 5% KOH Group, Partial response occurred in 6 (20%) in 10% KOH group while 15 (50%) in 5% KOH group, No response occurred in 1 (3.33%) in 10% KOH group and 9 (30%) in 5% KOH group (p<0.001). Conclusion: 10% Potassium Hydroxide (KOH) is an efficient modality for the treatment of molluscum contagiosum compared to 5% Potassium Hydroxide (KOH).

Chemo-prophylaxis of COVID-19 with hydroxychloroquine: a study of health care workers attitude, adherence to regime and toxicities/side effects (Preprint)

2020 ◽  
Author(s):  
Debajyoti Bhattacharyya ◽  
Neeraj Raizada ◽  
Bharathnag Nagappa ◽  
Arvind Tomar ◽  
Prateek Maurya ◽  
...  
Keyword(s):  
Side Effects ◽  
Health Care Workers ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Perceived Threat ◽  
Care Hospital ◽  
Care Workers ◽  
Perceived Danger ◽  
Structured Questionnaire

BACKGROUND There are apprehensions among healthcare worker (HCWs) about COVID-19. The HCWs have been given hydroxychloroquine (HCQ) chemo-prophylaxis for seven weeks as per Government of India guidelines. OBJECTIVE To assess the apprehensions among HCWs about COVID-19 and to document accessibility, adherence and side effects related to HCQ prophylaxis in HCWs. METHODS A longitudinal follow up study was conducted in a tertiary care hospital. HCQ was given in the dose of 400 mg twice on day one, and then 400 mg weekly for seven weeks. 391 HCWs were interviewed using semi structured questionnaire. RESULTS 62.2% HCWs expressed perceived danger posted by COVID-19 infection. Doctors (54%) showed least acceptance and paramedics (88%) showed highest acceptance to chemo-prophylaxis. 17.5% participants developed at least one of the side effects to HCQ. Females and nursing profession were significantly associated with adverse effects. Common side effects were gastro-intestinal symptoms, headache and abnormal mood change. Most of these were mild, not requiring any intervention. Gender, professions and perceived threat of COVID-19 were significantly associated with acceptance and adherence to HCQ prophylaxis. CONCLUSIONS Two third of HCWs had perceived danger due to COVID-19. Three fourth of the HCWs accepted chemo-prophylaxis and four out of five who accepted had complete adherence to prophylaxis schedule. One out of five had developed at least one of side effects; however, most of these were mild not requiring any intervention.

scholarly journals The effect of care transition pathway implementation on patients undergoing joint replacement during the COVID-19 pandemic: a quasi-experimental study from a tertiary care hospital orthopedic department in Beijing, China

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ya-ping Xu ◽  
Pei-yu Zhao ◽  
Yi-tong Bai ◽  
Shuang Li
Keyword(s):  
Joint Replacement ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Transition ◽  
Control Group ◽  
Care Hospital ◽  
Quasi Experimental ◽  
And Control ◽  
Beijing China

Abstract Background The coronavirus disease (COVID-19) pandemic has had a massive impact on individuals globally. The Chinese government has formulated effective response measures, and medical personnel have been actively responding to challenges associated with the epidemic prevention and control strategies. This study aimed to evaluate the effect of the implementation of a care transition pathway on patients that underwent joint replacement during the COVID-19 pandemic. Methods A quasi-experimental study was designed to evaluate the effect of implementing a care transition pathway for patients who underwent joint replacement during the COVID-19 pandemic in the orthopedic department of a tertiary care hospital in Beijing, China. Using a convenient sampling method, a total of 96 patients were selected. Of these, 51 patients who had undergone joint replacement in 2019 and received treatment via the routine nursing path were included in the control group. The remaining 45 patients who underwent joint replacement during the COVID-19 epidemic in 2020 and received therapy via the care transition pathway due to the implementation of epidemic prevention and control measures were included in the observation group. The quality of care transition was assessed by the Care Transition Measure (CTM), and patients were followed up 1 week after discharge. Results The observation group was determined to have better general self-care preparation, written planning materials, doctor-patient communication, health monitoring, and quality of care transition than the control group. Conclusions A care transition pathway was developed to provide patients with care while transitioning through periods of treatment. It improved the patient perceptions of nursing quality. The COVID-19 pandemic is a huge challenge for health professionals, but we have the ability to improve features of workflows to provide the best possible patient care.

scholarly journals PITYRIASIS ROSEA MIMICKING POLYMORPHIC ERUPTIONS OF PREGNANCY

2017 ◽  
Vol 10 (10) ◽  
pp. 21
Author(s):  
Balaji Ommurugan ◽  
Amita Priya ◽  
Swaminathan Tambaram Natesh
Keyword(s):  
Pregnancy Outcomes ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
First Trimester ◽  
Adverse Outcomes ◽  
Unknown Etiology ◽  
Care Hospital ◽  
Pityriasis Rosea ◽  
Human Herpes Virus

ABSTRACTPityriasis Rosea is a self-limiting skin disorder of unknown etiology affecting women more than men. It is very rare in pregnancy and evidence shows conflicting reports on pregnancy outcomes related to Pityriasis Rosea. But however recent evidence says, pregnancy outcomes are not altered, although clinicians must monitor the patient throughout the gestation for adverse outcomes. Hence, we report a case of Pityriasis Rosea infection in a primigravida, in the first trimester and the follow up done in a tertiary care hospital in Southern India.KEYWORDSRASH, FIRST TRIMESTER, ANOMALY SCAN, HUMAN HERPES VIRUS

scholarly journals Incidence of appendicitis and ovarian cyst among female patients presenting with acute abdomen at a tertiary care hospital

2018 ◽  
Vol 6 (12) ◽  
pp. 3838
Author(s):  
E. Chandrasekhara Reddy ◽  
Janaki Vellanki
Keyword(s):  
Acute Abdomen ◽  
Ovarian Cyst ◽  
Renal Colic ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Time Rate ◽  
Delayed Wound Healing ◽  
Female Patients

Background: Physicians working in casualty are often confronted with acute abdomen and get much more bothered as the diagnosis is not easy. This is due to the fact that the etiology of acute abdomen is always much diversified and the classical findings are masked making the diagnosis difficult. Objective was to study incidence of appendicitis and ovarian cyst among female patients presenting with acute abdomen.Methods: A hospital based follow up study was carried out among 64 cases presented with acute abdomen to the casualty from January 2018 to August 2018. All necessary investigations were done to confirm the etiology of acute abdomen. The cases belonged to surgery and gynecology departments where they were operated. The patients were followed from admission in the casualty to the final outcome. The data was analyzed using proportions.Results: During the study period a total of 15413 patients were admitted in the casualty out of them, 64 (0.42%) presented with acute abdomen. Of these 64 cases, majority i.e. 35 (54.7%) were due to acute appendicitis; 13 cases were due to renal colic and eight cases each were due to ectopic pregnancy and ovarian cyst. The most common age group affected was 21-30 years (62.5%) followed by less than 20 years age (21.9%). 25% of the 64 cases had delayed wound healing and no other complications were reported. No death was recorded.Conclusions: Authors achieved excellent results as there were no major complications and no death was recorded. Thus, meticulous diagnosis and prompt treatment can save patient life and at the same time rate of complications can be reduced.

A follow-up study to evaluate psychological impact among patients admitted for COVID-19 treatment to a tertiary care hospital

2021 ◽  
Vol 7 (2) ◽  
pp. 128
Author(s):  
RajKiran Donthu ◽  
AbdulSalaam Mohammed ◽  
SankarReddy Tamanampudi Pratap ◽  
RamyaKrishna Kurma
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Psychological Impact ◽  
Care Hospital ◽  
Follow Up Study

Opportunistic infection at the start of antiretroviral therapy and baseline CD4+ count less than 50 cells/mm3 are associated with poor immunological recovery

2019 ◽  
Vol 30 (2) ◽  
pp. 163-171
Author(s):  
Amod Tilak ◽  
Smita Shenoy ◽  
Muralidhar Varma ◽  
Asha Kamath ◽  
Amruta Tripathy ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Opportunistic Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hiv Positive ◽  
P Value ◽  
Care Hospital ◽  
Long Term Treatment ◽  
Immunological Recovery

AbstractIntroductionThere is a dearth of studies assessing the efficacy and immunological improvement in patients started on antiretroviral therapy (ART) in India. This study was undertaken to assess the 2-year treatment outcomes in HIV-positive patients initiated on ART in a tertiary-care hospital.MethodsAfter approval from the Institutional Ethics Committee, adult HIV-positive patients from a tertiary-care hospital, initiated on ART between January 2013 and February 2015, were included in the study. Data on clinical and immunological parameters were obtained from medical case records over a period of 2 years after initiation of therapy. Intention-to-treat analysis was done using a descriptive approach, using SPSS version 15 (SPSS Inc. Released 2006. SPSS for Windows, Version 15.0. Chicago, SPSS Inc.). A logistic regression analysis was done to assess the predictors for poor outcomes. A p-value <0.05 was considered statistically significant.ResultsART was initiated in 299 adult patients. At 1 and 2 years, the median (interquartile range) change in CD4+cell count was 65 (39, 98) cells/mm3and 160 (95, 245) cells/mm3. The change observed after 2 years of treatment initiation was statistically significant compared with that after 1 year. Three deaths occurred during the study period and 28 were lost to follow-up. Male sex, presence of at least one opportunistic infection at the start of therapy, and baseline CD4+count <50 cells/mm3were associated with poor immunological recovery.ConclusionsWith long-term treatment and regular follow-up, sustained clinical and immunological outcomes can be obtained in resource-limited settings.

Prevalence of Sudden Speechlessness in Critical Care Units

2011 ◽  
Vol 20 (4) ◽  
pp. 439-447 ◽  
Author(s):  
Loris A. Thomas ◽  
Carmen S. Rodriguez
Keyword(s):  
Critical Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Hospital Data ◽  
Care Environment ◽  
Critical Care Units ◽  
Clinical Diagnoses ◽  
Unit Characteristic

Sudden speechlessness (SS) is commonly experienced by patients admitted to critical care units. Although literature findings document challenges associated with periods of SS, the prevalence is unknown. The purpose of this study is to determine the prevalence and characteristics of adult SS patients in four critical care units at a university-affiliated tertiary care hospital. Data are collected on 9 randomly selected days over a 4-month period. The daily prevalence of SS ranges from 16% to 24% in each unit. Characteristic data collected includes patient age, gender, medical diagnosis related to SS episode, type of speechlessness, days since SS began, and communication strategies in use. Respiratory intubation related to various clinical diagnoses is the main cause for SS. Use of multiple specific strategies to convey needs during SS periods are identified. Follow-up studies to further define the prevalence of SS in settings beyond the critical care environment are recommended.

Retrospective Analysis of 1230 Patients of Immune Thrombocytopenic Purpura Reporting to a Tertiary Care Hospital in India from 1992–2004.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 5294-5294
Author(s):  
Dharma R. Choudhary ◽  
Rajat Kumar ◽  
R. Saxena ◽  
Manoranjan Mahapatra ◽  
Atul Kotwal ◽  
...  
Keyword(s):  
Developing Countries ◽  
Response Rate ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cost Effective ◽  
Repeated Measure ◽  
Care Hospital ◽  
Chronic Itp ◽  
Acute Itp

Abstract Background: There is very little published epidemiological data from developing countries regarding ITP and no large series from India. The aim of the study was to analyze the presenting features, response to different therapeutic options and suggest cost effective therapy. Method: The records of hematology department of All India Institute Of Medical Science were analyzed from January 1992 to June 2004. This is a premium tertiary care hospital in India. Diagnosis of ITP was made according to the standard criteria. Response criteria: complete response was defined as a platelet count increase to 100x109 /l or more, for at least 2 months: partial response was defined as doubling of platelet counts from initial levels and &gt; 50x 109/l for at least 2 months; no response included none of the above. Statistical methods: Database was created in MS Access and SPSS ver 11 was used for statistical analysis. Descriptive statistics were calculated and appropriate tests of significance like Chi Square, repeated measure linear model were carried out. Results: During the study period, 1230 patients of ITP were seen in hematology department, with a median age of 19.6 years (range 0.9–80). Females were 51.1% and males 48.9%. Median follow-up was of 9 months (range 0–178). Presenting features were: skin bleed − 91.1%; mucosal bleed − 57.5%; hematuria − 7.2%; gastrointestinal bleed − 12.5% and intracraniall bleed − 2.8%. Per-vaginal bleeding − 31.2 % of females. History of preceding viral fever was seen in 13.1% and palpable spleen in 2.5%. The mean platelet counts at presentation were 34+ 18.3x109/l. There were 595 (48.4%) patients of acute ITP and 635 (51.6%) patients of chronic ITP. Childhood ITP (age ≤ 12 yr) was seen in 46.5% and adult ITP in 53.5%. Response to therapy: Prednisolone was given to 99.6% patients with response of 57.3 %; Intravenous gamma globulin was given to 8.9% with response in 63.6%. Splenectomy was performed in 5% of acute ITP and 15.1% of chronic ITP (p = 0.00). The overall number of splenectomies was 126, with a response rate of 83.3%. Of these 126, acute ITP constituted 23.8% while chronic ITP formed 76.2% of cases. There was no statistically significant difference in response rate in these two groups (p =0.575). Danazole was given to 66 patients with response in 44%. Various other modalities of treatment were given to 24 patients (Anti D-14; Dapsone-2; Cyclosporin-2; Azathioprine-5; and Vincristine with Cyclophosphamide -1 patient), with a response in 25% of patients. The overall response rate with all treatment modalities was 68%: in childhood ITP − 65% and in adult ITP − 70.5%. Childhood ITP did not respond as expected, possibly due to referral bias of more refractory cases being referred to the center. The values of platelets showed a continuous increase during follow up and this increase was statistically significant (P=0.000 for all, Repeated measure model). Conclusion: Pattern of ITP in India is similar to that seen in other centers. In this study Prednisolone was given as first line agent to almost all patients with response in 57.3%; Splenectomy were done in 10.2% of prednisolone refractory or dependent patients with a response in 83.3%. These should form the primary modalities of therapy in developing countries. Significant numbers of patients were refractory to above-mentioned modalities and thus there is a requirement for other cost-effective therapies.

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